Relationship between Anxiety Score and Erythrocyte Sedimentation Rate (ESR) in Hemodialysis Patient
Abstract
Background: Anxiety in hemodialysis patients often impaired quality of life. Complex interaction between Chronic Kidney Disease (CKD) and anxiety are dynamic and multifactorial, including socio-economic, lifestyle and biological factors. Biological factors are closely related to anxiety in CKD including the immune system, inflammatory pathways of disorders of Hypothalamic-Pituitary-Adrenal Axis (HPA). Erythrocyte sedimentation rate (ESR) is one of the non-specific inflammatory marker that show the degree of inflammatory reaction, Neutrophil-Lymphocyte Ratio (NLR) and Platelet-Lymphocyte Ratio (PLR) also found as an easy and inexpensive measureable marker to show the degree of inflammation. This study aimed to examine relationship between anxiety and hematology inflammation markers in hemodialysis patient.
Subjects and Method: This was an observational study with a cross-sectional design. The study was conducted at Dr. Moewardi general hospital, Surakarta, Central Java. A sample of 30 hemodialysis patients was selected for this study. The dependent variables were ESR, NLR, and PLR. The independent variable was anxiety. Anxiety was measured by Taylor Manifest Anxiety Scale (TMAS). Data on ESR, NLR, and PLR, were measured using an assessment from RAND Corporation. The data were analyzed by a multiple linear regression.
Results: Anxiety increased NLR and it was marginally significant (b= 0.37; 95% CI= -0.01 to 0.22; p= 0.080). Anxiety decreased ESR and it was statistically significant (b= -0.57; 95% CI= -0.02 to 0.01; p<0.001). Anxiety decreased PLR (b= -0.16; 95% CI= -0.02 to 0.01; p= 0.440) and duration of hemodialysis (b= -0.27; 95% CI= -0.03 to 0.01; p= 0.167), but they were statistically non-significant.
Conclusion: Anxiety increases NLR. Anxiety decreases ESR, PLR, and duration of hemodialysis.
Keywords: chronic kidney disease, hemodialysis, hematology markers, inflammation
Correspondence: Rohmaningtyas Hidayah Setyaningrum. Department of Psychiatry, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi General Hospital, Surakarta, Central Java. Email: astitdr@gmail.com
Indonesian Journal of Medicine (2020), 05(02): 109-115
https://doi.org/10.¬26911/theijmed.2020.05.02.03
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